Dr. Eamon Croke:

I will refer back to care for children and the need for sedation and general anaesthetics. This is a very distressing situation. I have experience of people who are profoundly disabled and in acute agony. That is the easiest way to describe it. A mum and dad are listening to adult children crying and hitting their heads against the wall and everything else. There are no facilities for them. It adds a real human side to what is being described. I was also informed last night there would be certain help in this from the private sector. However, I am told that for paediatric dentistry, general anaesthetics are becoming more difficult in private hospitals. It is a problem that will increase in the near future.

With regard to the legislation, it is not fit for purpose. I am not sure if the Senator is aware, but in October 2021, the Dental Council put in a good submission on changing and updating the legislation. The legislation needs to be updated from beginning to end. Because of the emergency situation existing in certain parts of the legislation, the Dental Council will accept more of a piecemeal approach. However, I advise the committee that it should advocate for a complete change.

The other issue when talking about specialties relates to the frustration of how we move forward and how we stop just treating disease. We need to start thinking differently. Despite the amount we spend on it, Ireland is ranked 80th in the world in the WHO ranking of health services. We are spending a lot of money and not getting results. It is clear that we need to change how we approach dentistry. We need to plan for the future. Specialties are part of it. Special care is very much part of it. Other countries such as the UK and France have described disabilities from the cradle to the grave. As members are probably all aware, we are living longer and our medical problems are becoming more complex. As dentists, we know that. More children survive neurodisabilities. The specialty need exists and I encourage the committee to encourage the Minister and the Department to address it. As Mr. Hourihan said, this could be something the Minister could do outside the Act. He has the capacity to do that. There are requirements for the ability to register and inspect practices and to have continuing education. They are headline needs for the safety of patients. I encourage this committee to get changes and to get the Department focused on a fit for purpose Act.